Multiple disciplines must be employed to fully elucidate and appreciate the pain experience. Following chronicity descending modulatory pathway plasticity occurs. Structures above the brainstem, including the cortex and amygdala, contribute to the descending control of pain, and these regulatory controls influence emotional and sensory qualities of the pain experience. We are beginning to understand the plasticity of the dynamic pain connectome and how individual variability in the dynamic pain connectome reflects pain sensitivity.

In this workshop Dr. Bannister (King’s College London, London) and Professors Porreca (University of Arizona, Tuscon) and Davis (University of Toronto, Toronto) present novel and insightful research data obtained using behavioural, electrophysiological and neuroimaging techniques. Emphasis will be placed on the spinal and supra-spinal pharmacology of diffuse noxious inhibitory controls, specifically relating to how these unique descending pathways are differentially regulated in the normal versus chronic pain (neuropathic) situation. A discussion of endogenous opioid signalling in descending modulatory pathways will lead to analysis of novel therapeutic strategies. Finally, a framework for understanding brain circuitry underlying individual variability in pain perception will be considered; recent data has localised specific sites of connectome plasticity, reflecting chronic pain treatment outcomes.

Learning Objectives:

• Upon completion of this session attendees will understand descending modulatory pathway plasticity following chronicity
• Upon completion of this session attendees will understand the contribution to descending pain modulation from the cortex and the amygdala and modulatory influences on emotional and sensory qualities of pain.
• Upon completion of this session attendees will have an understanding of the plasticity of the dynamic pain connectome and how individual variability in the dynamic pain connectome reflects pain sensitivity.